Itatsu T, Miwa H, Murai T, Terai T, Ohkura R, Sorimachi S, Yang S W, Ogihara T, Watanabe S, Hirai S, Sato N
Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan.
J Gastroenterol. 1997 Jun;32(3):389-95. doi: 10.1007/BF02934498.
A case of early esophageal adenocarcinoma arising in Barrett's esophagus is reported. Many cases of Barrett's esophagus, which is considered a premalignant condition, have been reported in Western countries, but few cases have been reported in Japan. The patient, a 53-year-old man with nausea and vomiting, was a drinker (four glasses wine/day for about 30 years), but did not smoke. He had had a hiatal hernia of the esophagus. Since endoscopic biopsies demonstrated an early adenocarcinoma in Barrett's esophagus, subtotal esophagectomy was performed. In the resected esophageal material, Barrett's esophagus was seen to extend for 12 cm. In addition to the cancer detected preoperatively as a 0-IIc lesion (1.5 cm in diameter), a 0-IIb lesion (1.5 cm in diameter) was also detected in the postoperative survey. Both lesions were well differentiated adenocarcinoma that had invaded only into the lamina propria mucosa. The 23 cases of early adenocarcinoma in Barrett's esophagus that have been reported in Japan were reviewed, and it was learned that the present case is the second of multiple early cancer arising in Barrett's esophagus so far reported in Japan.
报告了1例起源于巴雷特食管的早期食管腺癌病例。西方国家已报道了许多被认为是癌前病变的巴雷特食管病例，但日本报道的此类病例较少。该患者为53岁男性，有恶心和呕吐症状，饮酒（每天约4杯葡萄酒，持续约30年），但不吸烟。他患有食管裂孔疝。由于内镜活检显示巴雷特食管存在早期腺癌，遂行食管次全切除术。在切除的食管标本中，可见巴雷特食管延伸12 cm。除了术前检测到的直径为1.5 cm的0-IIc病变癌外，术后检查还发现了一个直径为1.5 cm的0-IIb病变。两个病变均为高分化腺癌，仅侵犯黏膜固有层。对日本已报道的23例巴雷特食管早期腺癌病例进行了回顾，发现本病例是日本迄今为止报道的巴雷特食管多发早期癌中的第二例。
